ATI Proctored Leadership Exam

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A nurse manager has two out of six staff nurses call in sick for one shift. Because of reduced availability of staff, the manager decides to manage the unit with the three remaining nurses, which keeps the unit at minimal staffing standards. What type of decision-making strategy would this be?

  • A. Satisficing
  • B. Routine
  • C. Adaptive
  • D. Rationalizing
Correct Answer: A

Rationale: The correct answer is A: Satisficing. Satisficing is a decision-making strategy where one aims to meet the minimum requirements or standards to achieve a satisfactory outcome given the constraints. In this scenario, the nurse manager chooses to manage the unit with the three remaining nurses to maintain minimal staffing standards, despite not having the full staff complement. This decision is based on satisficing as the manager is making the best of the situation with the available resources.

Summary:
B: Routine decision-making involves following established procedures and protocols, which may not be applicable in this situation.
C: Adaptive decision-making involves adjusting to changing circumstances, but in this case, the manager is not adapting to the situation but rather making do with limited resources.
D: Rationalizing decision-making involves justifying or explaining decisions, which is not the focus in this scenario where quick action is needed to maintain minimal staffing standards.

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The healthcare provider is developing a critical pathway for congestive heart failure (CHF). Which components are essential to include? (Select ONE that does not apply.)

  • A. Expected length of stay
  • B. Assigned staff healthcare provider
  • C. Patient outcomes
  • D. Medical diagnosis
Correct Answer: B

Rationale: The correct answer is B because the assigned staff healthcare provider is not an essential component in developing a critical pathway for congestive heart failure (CHF). The rationale is that the focus of a critical pathway is on standardizing the care process to improve outcomes and efficiency. Including specific assigned staff members may not be feasible due to staffing variations and may limit flexibility in care delivery. Expected length of stay (A) helps in planning resources, patient outcomes (C) are crucial for evaluating effectiveness, and medical diagnosis (D) guides treatment protocols. Therefore, choice B is not essential compared to the other components.

An RN knows that sometimes, when working through an ethical dilemma, the decision makers are unable to arrive at a mutually agreed upon decision. Which of the following is a reason why an agreement cannot be reached?

  • A. One or more of the parties may be able to reconcile their values.
  • B. The patient’s point of view is recognized as valuable.
  • C. The dilemma involves two or more equally unpleasant choices.
  • D. The institution is unable to honor the patient’s request.
Correct Answer: D

Rationale: The correct answer is D because if the institution is unable to honor the patient's request, it can create a barrier to reaching an agreement in an ethical dilemma. If the institution cannot support the patient's wishes, it can lead to conflicting viewpoints and hinder consensus. In contrast, choices A, B, and C do not directly address the institutional aspect and are not as relevant to the primary reason for the inability to reach an agreement in this context. Choice A focuses on individual values, choice B emphasizes the patient's perspective, and choice C pertains to the nature of the dilemma itself rather than external factors like institutional limitations.

A resident on night call refuses to answer pages from the staff nurse on the night shift and complains that she calls too often with minor problems. The nurse feels offended and reacts with frequent, middle-of-the-night phone calls to 'get back' at him. The behavior displayed by the resident and the nurse is an example of what kind of conflict?

  • A. Perceived conflict
  • B. Disruptive conflict
  • C. Competitive conflict
  • D. Felt conflict
Correct Answer: B

Rationale: The correct answer is B: Disruptive conflict. This type of conflict occurs when there is a lack of cooperation and communication between parties, leading to negative interactions. In this scenario, the resident and nurse are engaging in retaliatory behavior, causing disruption in their professional relationship. The resident's refusal to answer pages and the nurse's excessive phone calls are escalating the conflict, impacting their ability to work effectively as a team.

A: Perceived conflict refers to misunderstandings or misinterpretations of others' actions. In this case, the conflict is real and evident.
C: Competitive conflict involves a desire to win or outperform others. While there may be some competitiveness in their actions, the main issue is the disruptive nature of their conflict.
D: Felt conflict describes emotional responses to conflict situations. While emotions are likely present in this scenario, the key aspect is the disruptive nature of their behavior.

A registered nurse (RN) is caring for a patient who is one of Jehovah’s Witnesses and has refused a blood transfusion even though her hemoglobin is dangerously low. After providing information about all the alternatives available and risks and benefits of each, the health-care provider allows the patient to determine which course of treatment she would prefer. The RN knows this is an example of which ethical principle?

  • A. Autonomy
  • B. Nonmaleficence
  • C. Beneficence
  • D. Distributive justice
Correct Answer: A

Rationale: The correct answer is A: Autonomy. Autonomy refers to the patient's right to make their own decisions about their healthcare, including the choice to refuse treatment. In this scenario, the healthcare provider respects the patient's autonomy by providing information and allowing her to make an informed decision, even if it goes against medical advice. This upholds the patient's right to self-determination and control over her own body.

Summary:
B: Nonmaleficence - This principle focuses on doing no harm to the patient, but in this case, respecting the patient's autonomy takes precedence.
C: Beneficence - This principle involves acting in the patient's best interest, but in this scenario, respect for autonomy is the primary consideration.
D: Distributive justice - This principle is about fair distribution of resources and care, which is not directly relevant to the patient's right to make decisions about her own treatment.

A client is having difficulty breathing while receiving supplemental oxygen via a nasal cannula in a supine position. Which of the following interventions should the nurse take first?

  • A. Suction the client's airway.
  • B. Instruct the client to perform incentive spirometry every hour.
  • C. Assist the client to an upright position.
  • D. Humidify the client's supplemental oxygen.
Correct Answer: C

Rationale: The correct answer is C: Assist the client to an upright position. This is the priority intervention because placing the client in an upright position helps improve lung expansion and oxygenation by optimizing ventilation-perfusion matching. This position also reduces the risk of aspiration and improves overall respiratory function.

Choice A (Suction the client's airway) is not the first intervention because difficulty breathing in this scenario is more likely due to positioning rather than airway obstruction.

Choice B (Instruct the client to perform incentive spirometry every hour) is not the first intervention as it may not address the immediate issue of breathing difficulty related to supine positioning.

Choice D (Humidify the client's supplemental oxygen) is not the first intervention as lack of humidification is not likely the cause of the client's difficulty breathing in this situation.

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